internet-based a-cra for young adults with problematic alcohol use

Conditions: Alcohol Abuse; Binge Drinking; Alcohol Use Disorder

Summary: the primary aim of the study is to evaluate the feasibility and acceptability of an internet-delivered adolescent community reinforcement approach (i-a-cra) with therapist support for young adults (aged 18-24 years) with problematic alcohol use and their caregiver/significant other. secondary aims include investigating the role of comorbid emotional symptoms, emotion regulation and prosocial behavior in treatment outcomes for the young adults. in a randomized controlled pilot trial, participants (n = 60 young adults as well as an optional accompanying caregiver/significant other) will be recruited from the community through advertisements as well as through clinic referrals in stockholm, sweden. eligible participants will be randomized either to the 10-week i-a-cra treatment or to an active control group (receiving psychoeducation about alcohol use over the same time frame). in both conditions an optionally accompanying caregiver/significant other will receive a support program in conjunction with the young adult's treatment. participating young adults will be evaluated with regards to their alcohol use, psychiatric symptoms, emotion regulation, and prosocial behavior at pre-treatment, weekly during treatment, post-treatment, and at a 3-month follow-up. the primary outcome will be feasibility (measured as number of treatment completers; i.e., having completed 5 out of 8 treatment modules), and acceptability (measured by patient satisfaction). secondary outcomes will include pre- and post-treatment self-rated binge drinking episodes, levels of depression, anxiety and stress, emotion dysregulation, and prosocial behavior. self-reports regarding stress, emotion dysregulation, and prosocial behavior will be complemented by behavioral measures (computerized tasks).


Eligibility criteria:
inclusion criteria: * young adult between 18-24 years of age * reporting ongoing substance use (alcohol), heavy drinking measured as risky use according to recommendations: 5/4 (male/female) standard drinks on a minimum of two occasions in the last month, or audit-c ≥ 4 points indicating harmful consumption * access to internet via computer or other similar device, as well as access to smartphone * if on psychiatric medication, it should have been a stable dosage during the past 3 months prior to pre-treatment assessment * adequate knowledge in the swedish language and a swedish personal identification number exclusion criteria: * current dsm-5 diagnosis for any other substance use disorder except nicotine dependence * current (including last 12 months) dsm-5 diagnosis for other major psychiatric disorder (bipolar disorder, psychosis) * recent initiation of psychiatric medication or psychotherapy (within the last 3 months) * suicidal ideation at screening * serious somatic diagnosis requiring medical attention, such as uncontrolled diabetes mellitus, epilepsy or heart conditions * traces of any psychoactive substance (e.g., central stimulant amines, thc, benzodiazepines, opiates, cocaine) in urine sample at baseline assessment * pregnancy

Keywords: randomized controlled trial alcohol internet-delivered psychological treatment behavior therapy young adults